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Entries in exercise (6)


pH & exercise

I found an article in the December 2013 issue of Velo, the high-performance bicycling magazine, that piqued my interest because it gets into biochemistry. The article "Understading the Burn, Lactic Acid Myths Debunked" by Trevor Connor points out that lactic acid exists as a buffer with its conjugate base lactate. Our blood's pH is carefully kept near a constant somewhere between 7.35 and 7.46. If we wander even a bit out of this range, we face imminent danger and death. We never get systemically acidic. What can build up locally in those muscles is hydrons (H+). These are quickly removed by the lactate (the base).

Professor Matthew Hickey, head of the Human Performance Research Lab at Colorado State University, has been studying the physiology of this buffer system.

In reality "lactate serves many important roles. For example, "it is the principle fuel for the heart during vigorous exercise," Hickey said. And the liver can recycle it, "releasing a brand new glucose molecule as if you'd been drinking a sports drink."

Remember this formula for repiration from biology or physiology class?

C6H12O6 (s) + 6 O2 (g) → 6 CO2 (g) + 6 H2O (l) + heat

Professor Hickey says that humans have no problem acquiring enough oxygen. Our lungs are overly large; we only need 2/3 capacity to achieve optimal oxygen levels. It's the exhaling of carbon dioxide that moves us to fatigue, sore muscles and out of breath.

Our best immediate buffer is a molecule called bicarbonate. Bicarbonate binds to acid to produce harmless water and CO2. However, "that process is only as good as the last step, which is breathing off the carbon dioxide." If we don't breath it off fast enough, the CO2 is converted back to acid, and we lose the race. The takeaway? Concentrate on exhaling.

How to get the best exhale for your efforts? Improve your circulation! That means slow but long training hours, keeping warm, breathe deeply and effect long, deliberate exhales. You can also eat fewer carbs in order to train "fat reliance". Utilizing fats for energy rather than carbs reduces the fluctuations in pH and the concomitant activity of the buffer system. It makes you more efficient. Lastly, exercise at threshold.

"There are ways to train your heart, your less frequently used muscles, and your liver to better clear hydrogen ions," Hickey said. "And, not surprisingly one of the ways to do that is to bathe those tissues regularly in lactate." Start with short five-minute threshold efforts. Then as your clearance systems improve, build to 20 and even 30-minute efforts.

So no need to worry about or spend money on products promising to clear your lactic acid or lactate. You need it. It's working for you. Focus instead on your breathing and on promoting your circulation.




Skeletal muscles have tone and strength. The two are often confused because in normal parlance we say that someone who has built their muscle strength, by say, weight lifting or physical activity, is 'toned'. This is not what we are referring to when pointing to muscle function.

'Muscle tone' refers to the work the muscle is doing when it is at rest, while the work that muscles do while working, or exerting force, is called 'strength'.

All muscles maintain some working fibers, even while at rest. This reflects a certain amount of electrical and chemical communication that constantly happens in order to maintain basic functions such as proprioception, balance or just structure. Those muscles that have some responsibility for posture have more slow-twitch fibers and will have greater resting tone. Slow-twitch fibers are the "white meat" of muscle. Like birds who must fly hundreds of miles to migrate, they are working much of the time to keep up some tone for endurance. The need for postural and structural support never sleeps. When some fibers need to rest, others jump in to take over. The pelvic floor is postural and is prone to hypertonicity. Hypertonic fibers are those that do too much work while at rest. A muscle that doesn't rest can't work as well and can produce pain. Most patients who show up at American pelvic pain clinics or complain of urinary symptoms present with hypertonic pelvic floors.

Muscles at work are characterised as strong or weak. Both can be hypertonic (or hypotonic, for that matter--meaning too flaccid at rest). When women are given a vaginal digital exam by a urologist in order to assess for strength, it can be difficult to accurately assess the strength of a hypertonic pelvic floor. If the muscle contracts but doesn't adequately relax afterwards, the physician will feel little difference in tension and proclaim the muscle group to be weak. What the practitioner actually felt was the result of hypertonicity and the jury is still out on the strength or weakness.

A female urologist (one who is trained on female anatomy & physiology) is more likely to be aware of this issue than the more traditional male urologist. Nearly all urologists are male urologists.

I have had patients who become concerned that exercise will worsen hypertonicity. This could not be further from the truth. When we work a muscle, we contract and relax it, over and over. In working the muscle we train the relaxation part of the cycle as much as the contraction. In fact, working the muscle is one way of treating hypertonicity.

For the pelvic floor, there are two more ways that we can aid relaxation of the muscles. One is to give a slight push out, like giving a little push to get a tampon out. It should never be a forceful or strained push; use very little effort and don't expect to feel anything different from doing it. The other way to relax the pelvic floor is to lie in rest pose--on one's back, with knees bent and soles of the feet touching each other. This minimizes the electrical activity from the large muscles of the thighs and buttocks that tends to spill into the pelvic floor. This electrical activity is normal, but too much of it promotes hypertonicity.


The weighted bladder

Research shows that bladder dysfunction is affected by changes in body weight. Even a five pound increase in weight can adversely affect a bladder already experiencing symptoms. The good news? A five pound decrease in weight can lessen the stress on the organ and, hence, mitigate the experience of bladder symptoms.


Sensory awareness

Since sensory awareness drives motor control, promotes sensory integration and helps to develop relationship with one's body, I've been adding sensory awareness exercises to my Core & Pelvic Floor Workout classes these past couple weeks. It is a trend I will continue.

This past week my participants and I were noticing how very minute shifts in our position--pointing a foot or leaning--can elicit profound changes in sensory perception. When one has increased awareness one enhances one's ability to control those muscles and the surrounding structures. As Janet Hulme, PT, avers, "Even muscles you are not aware of being able to control, like the bladder, are affected when you change muscles you can control." Perhaps this can be one definition of the subconscious life, connecting the unconscious and supposedly uncontrollable with the conscious and controllable. In politics the Chinese call this approach 'using the back door'. In biology it's sometimes called neuroplasticity.

Try this:

Move ever so slowly to a sitting position, paying particular attention to how your sitz bones (ischia) are moving. You should notice that as you sit, your sitz bones are spreading, moving away from each other, until the moment before sitting. As you release the tension to let yourself give your weight to the chair, the sitz bones move toward each other slightly. Do it several times in attemp to feel it.

Squat down and perform a slow, side to side swing of your buttocks. Notice the pull you feel on your opposign sitz bone. In other words, when you are swinging to your right, you should feel a slight pull on your left sitz bone. When you swing to your left, you feel that pull on your right sitz bone.

These simple exercises, and others like them, can aid in restoring normal sensation and function, when practiced over time.


Never do sit ups or crunches

No one should ever do sit ups or crunches anywhere, for any reason, ever. Not ever.

Medical organizations and medical professionals have come out against the exercises for reasons dependent on their focus:  Orthopedic and geriatric organizations are concerned about the inordinate pressure exerted on the thoracic spine and the propensity for back injury. OB/Gyn's and professionals interested in child development note the inordinate pressure exerted on the pelvic and abdominal organs and on the pelvic floor (from a direction that promotes prolapse).

Exercise specialists disown the exercises because they don't work and because they recruit the use of and end up working the psoas, a muscle you don't want to work in this way or you run the risk of chronic low back pain. There is a finite number of flexes in your spine before it fatigues, leaving it prone to disc herniation. This is called 'fatigue life'; sit ups and crunches are pronounced flexions.

All abdominal work should be done by engaging the transverse abdominus (by pushing out the TA just above the pubic bone) and moving the legs. This can be done with a person in plank position or on her back.

But never, ever do sit ups or crunches. Your back and your bottom will thank you.